title: What is the role of apelin regarding cardiovascular risk and progression of renal disease in type 2 diabetic patients with diabetic nephropathy?
abstract: OBJECTIVE
  To evaluate the association of different apelin levels with cardiovascular mortality, hospitalization, renal function, and cardiovascular risk factors in type 2 diabetic patients with mild to moderate CKD.
  
  
  METHODS
  An observational, prospective study involving 150 patients divided into groups according to baseline apelin levels: 1 ≤ 98 pg/mL, 2 = 98-328 pg/mL, and 3 ≥ 329 pg/mL. Baseline characteristics were analyzed and compared. Multivariate Cox regression was used to find out predictors of cardiovascular mortality, and multivariate logistic regression was used to find out predictors of hospitalization and disease progression. Simple linear regressions and Pearson correlations were used to investigate correlations between apelin and renal disease and cardiovascular risk factors.
  
  
  RESULTS
  Patients' survival at 83 months in groups 1, 2, and 3 was 39%, 40%, and 71.2%, respectively (P = 0.046). Apelin, age, and eGFR were independent predictors of mortality, and apelin, creatinine, eGFR, resistin, and visfatin were independent predictors of hospitalization. Apelin levels were negatively correlated with cardiovascular risk factors and positively correlated with eGFR. Patients with lower apelin levels were more likely to start a depurative technique.
  
  
  CONCLUSIONS
  Apelin levels might have a significant clinical use as a marker/predictor of cardiovascular mortality and hospitalization or even as a therapeutic agent for CKD patients with cardiovascular disease.
authors.affiliation: Nephrology Department, Hospital Faro, Rua Leão Penedo, 8000-386 Faro, Portugal.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Silva
authors.forename: André
authors.initials: A
authors.lastname: Fragoso
authors.forename: Claudia
authors.initials: C
authors.lastname: Silva
authors.forename: Carla
authors.initials: C
authors.lastname: Viegas
authors.forename: Nelson
authors.initials: N
authors.lastname: Tavares
authors.forename: Patrícia
authors.initials: P
authors.lastname: Guilherme
authors.forename: Nélio
authors.initials: N
authors.lastname: Santos
authors.forename: Fátima
authors.initials: F
authors.lastname: Rato
authors.forename: Ana
authors.initials: A
authors.lastname: Camacho
authors.forename: Cidália
authors.initials: C
authors.lastname: Cavaco
authors.forename: Victor
authors.initials: V
authors.lastname: Pereira
authors.forename: Marilia
authors.initials: M
authors.lastname: Faísca
authors.forename: João
authors.initials: J
authors.lastname: Ataíde
authors.forename: Ilídio
authors.initials: I
authors.lastname: Jesus
authors.forename: Pedro
authors.initials: P
authors.lastname: Neves
mesh_terms: D000368:Aged; D000073861:Apelin; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000473:pathology; D003928:Diabetic Nephropathies / Q000097:blood* / Q000150:complications / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D012307:Risk Factors
chemical_list: C115436:APLN protein, human; D000073861:Apelin; D015415:Biomarkers; D036341:Intercellular Signaling Peptides and Proteins